Showing papers in "Chinese Medical Journal in 2008"

Curcumin improves learning and memory ability and its neuroprotective mechanism in mice.

Abstract: Background Increasing evidence suggests that many neurons may die through apoptosis in Alzheimer's disease (AD). Mitochondrial dysfunction has been implicated in this process of neuronal cell death. One promising approach for preventing AD is based upon anti-apoptosis to decrease death of nerve cells. In this study, we observed the memory improving properties of curcumin in mice and investigated the neuroprotective effect of curcumin in vitro and in vivo. Methods The mice were given AlCl(3) orally and injections of D-galactose intraperitoneally for 90 days to establish the AD animal model. From day 45, the curcumin group was treated with curcumin for 45 days. Subsequently, the step-through test, neuropathological changes in the hippocampus and the expression of Bax and Bcl-2 were carried out to evaluate the effect of curcumin on the AD model mice. In cultured PC12 cells, AlCl(3) exposure induced apoptosis. The MTT assay was used to measure cell viabilities; flow cytometric analysis to survey the rate of cell apoptosis; DNA-binding fluorochrome Hoechst 33258 to observe nuclei changes in apoptotic cells and Western blot analysis of Bax, Bcl-2 to investigate the mechanisms by which curcumin protects cells from toxicity. Results Curcumin significantly improved the memory ability of AD mice in the step-through test, as indicated by the reduced number of step-through errors (P 0.05). AlCl(3) significantly reduced the viability of PC12 cells (P 0.05). Conclusions This study demonstrates that curcumin improves the memory ability of AD mice and inhibits apoptosis in cultured PC12 cells induced by AlCl(3). Its mechanism may involve enhancing the level of Bcl-2.

Berberine ameliorates renal injury in streptozotocin-induced diabetic rats by suppression of both oxidative stress and aldose reductase.

Abstract: Background Berberine is one of the main constituents of Coptidis rhizoma (CR) and Cortex phellodendri. In this study, we investigated the beneficial effects of berberine on renal function and its possible mechanisms in rats with diabetic nephropathy (DN). Methods Male Wistar rats were divided into three groups: normal, diabetic model, and berberine treatment groups. Rats in the diabetic model and berberine treatment groups were induced to diabetes by intraperitonal injection with streptozotocin (STZ). Glomerular area, glomerular volume, fasting blood glucose (FBG), blood urea nitrogen (BUN), serum creatinine (Cr) and urine protein for 24 hours (UP24h) were measured using commercially available kits. Meanwhile, the activity of superoxide dismutase (SOD), content of malondialdehyde (MDA) in serum, activity of aldose reductase (AR) and the expression of AR mRNA and protein in kidney were detected by different methods. Results The results showed that oral administration of berberine (200 mg·kg -1 ·d -1 ) significantly ameliorated the ratio of kidney weight to body weight. Glomerular area, glomerular volume, FBG, BUN, Cr and UP24h were significantly decreased in the berberine treatment group compared with the diabetic model group (P<0.05). Berberine treatment significantly increased serum SOD activity and decreased the content of MDA compared with diabetic model group (P <0.05). AR activity as well as the expression of AR mRNA and protein in the kidney was markedly decreased in the berberine treatment group compared with diabetic model group (P <0.05). Conclusion These results suggested that berberine could ameliorate renal dysfunction in DN rats through controlling blood glucose, reduction of oxidative stress and inhibition of the activation of the polyol pathway. Chin Med J 2008;121(8):706-712

Variations of tumor necrosis factor-alpha, leptin and adiponectin in mid-trimester of gestational diabetes mellitus.

Abstract: BACKGROUND Many cytokines have been found to increase the insulin resistance during pregnancy complicated by glucose metabolism disorder. This study aimed to investigate which comes first, the changes of some cytokines or the abnormal glucose metabolism. METHODS This nested case-control study was undertaken from January 2004 to March 2005. Twenty-two women with gestational diabetes mellitus (GDM), 10 with gestational impaired glucose tolerance (GIGT), and 20 healthy pregnant women were chosen from the women who had visited the antenatal clinics and had blood samples prospectively taken and kept during their visit. The levels of tumor necrosis factor-alpha (TNF-alpha), leptin and adiponectin were determined. One-way ANOVA analysis and bivariate correlation analysis were used to assess the laboratory results and their relationship with body mass index (BMI). RESULTS Women with GDM have the highest values of TNF-alpha and leptin and the lowest value of adiponectin compared with those with GIGT and the healthy controls (P < 0.01) at 14-20 weeks of gestation. This was also found when these women progressed to 24-32 weeks. The significantly increased levels of TNF-alpha and leptin and the decreased level of adiponectin were found at the different periods of gestation within the same group. Positive correlation was shown between the levels of TNF-alpha and leptin at the two periods of gestation with the BMI at 14-20 weeks, while adiponectin was negatively correlated (P < 0.05). CONCLUSIONS The concentrations of TNF-alpha, leptin and adiponectin may change before the appearance of the abnormal glucose level during pregnancy. Further studies are required to verify the mechanism of this alteration and whether the three cytokines can be predictors for GDM at an early stage of pregnancy.

Anti-diabetic effects of cinnamaldehyde and berberine and their impacts on retinol-binding protein 4 expression in rats with type 2 diabetes mellitus.

Abstract: BACKGROUND Retinol binding protein 4 (RBP4), as an adipocyte secreted cytokine, was recently found to be inversely correlated with expression of glucose transporter 4 (GLUT4) in insulin resistance (IR) state and to have an intimate relationship with IR and type 2 diabetes mellitus (T2DM). The present study aimed to evaluate the anti-diabetic efficacy of cinnamaldehyde (Cin), berberine (Ber), and metformin (Met) as well as their impacts on the RBP4-GLUT4 system. METHODS Rat models of T2DM were established by combination of intraperitoneal injection of low-dose streptozotocin and high fat diet induction. Rats were divided into five groups: the control group, the diabetes group, the diabetes + Ber group, the diabetes + Cin group, and the diabetes + Met group. Western blotting was used to detect the serum or tissue RBP4 and GLUT4 protein levels. RESULTS After treatment for four weeks, both Cin and Ber displayed significant hypolipidemic, hypoglycemic, and insulin sensitizing functions (P < 0.01) compared with the control group. Their effects on lowering fasting plasma glucose (FPG), low density lipoprotein-cholesterol (LDL-C) and homeostasis model assessment of insulin resistance (HOMA-IR) seem even better than that of Met. Cin and Ber markedly lowered serum RBP4 levels and up-regulated the expression of tissue GLUT4 protein, and Cin seemed more notable in affecting these two proteins. CONCLUSIONS Both Cin and Ber display an exciting anti-diabetic efficacy in this study and may be of great value for the treatment of type 2 diabetes. Their mechanisms involve the RBP4-GLUT4 system, during which the serum RBP4 levels are lowered and the expression of tissue GLUT4 protein is up-regulated.

Inhibitory effect of ginsenoside Rg3 on ovarian cancer metastasis.

Abstract: Background Ginsenosides are main components extracted from ginseng, and ginsenoside Rg3 is one of the most important parts. Ginsenoside Rg3 has been found to inhibit several kinds of tumor growth and metastasis. The present study was undertaken to investigate the effect of ginsenoside Rg3 on human ovarian cancer metastasis and the possible mechanism. Methods The experimental lung metastasis models of ovarian cancer SKOV-3 and the assay of tumor-induced angiogenesis were used to observe the inhibitory effects of Rg3 on tumor metastasis and angiogenesis. The effect of Rg3 on invasive ability of SKOV-3 cells in vitro was detected by Boyden chamber, and immunofluorescence staining was used to recognize the expression of matrix metalloproteinase 9 (MMP-9) in SKOV-3 cells. Results In the experimental lung metastasis models of ovarian cancer, the number of tumor colonies in the lung and vessels oriented toward the tumor mass in each ginsenoside Rg3 group, was lower than that of control group. The invasive ability and MMP-9 expression of SKOV-3 cells decreased significantly after treatment with ginsenoside Rg3. Conclusions Ginsenoside Rg3 can significantly inhibit the metastasis of ovarian cancer. The inhibitory effect is partially due to inhibition of tumor-induced angiogenesis and decrease of invasive ability and MMP-9 expression of SKOV-3 cells.

Effects of vibration therapy on bone mineral density in postmenopausal women with osteoporosis.

Abstract: platform, with a vibration frequency of 30 Hz, amplitude of 5 mm; they received the treatment five times per week, ten minutes each time and totally for six months), whereas women of group B served as controls without any treatment. L2–4 BMD, bilateral femoral neck BMD, and body mass index (BMI) were recorded before the treatment or at the third and sixth months of the treatment respectively. After the ending of the treatment, the change of BMD in each group was compared and analyzed. Chronic back pain was evaluated by visual analogue scale (VAS) at baseline and the third and sixth months of the treatment. Results Of the 116 women, 94 including 51 women from group A ((61.23±8.20) years) and 43 women from group B ((63.73±5.45) years), completed the study. There were no significant differences in baseline characteristics including age, BMI, menopausal years, lumbar BMD, femoral neck BMD, and VAS between the two groups. The lumbar BMD of the 51 women in group A increased by 1.3% (P=0.034) after vibration treatment for 3 months and by 4.3% at the sixth month (P=0.000). The lumbar BMD in group B was decreased at the third month, but there was not statistical significance (P >0.05). At the sixth month, it was decreased by 1.9% (P 0.05). At the sixth month, the BMD was increased by 3.2% (P <0.05). In group B, the BMD was not decreased significantly (P=0.185) at the third month, but decreased significantly at the sixth month (1.7%) (P <0.05) compared with the baseline. Chronic back pain (VAS) reduced more significantly in group A at the third and the sixth months (P <0.05) after vibration therapy in comparison with the baseline. The BMI was not significantly changed in the two groups during the period of follow-up. Conclusions Vibration therapy appears to be useful in reducing chronic back pain and increasing the femoral neck and lumbar BMD in postmenopausal women with osteoporosis. Chin Med J 2008;121(13):1155-1158 haracterized by micro-structural changes and increase of brittleness of bone, osteoporosis is a fracture-prone disease with a generalized decrease of bone mass in the entire body. In the menopausal period, not only the growth of age causes the degenerative bone loss in women, but the loss of estrogen’s protective effects on skeletal structure also significantly accelerates this process. Furthermore, under normal circumstances, the peak bone mass of women is lower than that of men, leading to a higher incidence of osteoporosis in postmenopausal women. Pain, diseases, and fracture of bone, which are caused by osteoporosis, affect the quality of life for middle-aged and eldly women, and this has become an increasingly important public health issue.

Safety and feasibility of transradial approach for primary percutaneous coronary intervention in elderly patients with acute myocardial infarction.

Abstract: BACKGROUND Transradial coronary intervention has been widely used because of its effects in lowering the incidence of complications in vascular access site and improving patient satisfaction compared to the femoral approach. This study aimed to investigate the safety and feasibility of transradial approach for primary percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI). METHODS A total of 103 consecutive elderly patients (age = 65 years) who were diagnosed as having AMI were indicated for PCI. Among them, 57 patients received primary PCI via the transradial approach (transradial intervention, TRI group), and 46 underwent primary PCI via the transfemoral approach (transfemoral intervention, TFI group). The success rate of puncture, puncture time, cannulation time, reperfusion time, the total time for PCI, the success rate of PCI, the use rates of temporary pacemaker and intra-aortic balloon pump (IABP), and the total length of hospital stay of the patients in the two groups were compared. After the procedure, vascular access site complications and major adverse cardiovascular events (MACE) in the two groups in one month were observed. RESULTS The success rates of puncture (98.2% vs 100.0%) and PCI (96.5% vs 95.7%) for the patients in the TRI and TFI groups were not statistically significant (P > 0.05). The puncture time ((2.4 +/- 1.1) vs (2.0 +/- 0.9) minutes), cannulation time ((2.7 +/- 0.5) vs (2.6 +/- 0.5) minutes), reperfusion time ((16.2 +/- 4.5) vs (15.4 +/- 3.6) minutes), total time of the procedure ((44.1 +/- 6.8) vs (41.2 +/- 5.7) minutes), use rates of temporary pacemaker (1.8% vs 2.2%) and IABP (0 vs 2.2%) in the two groups were not statistically significant (P > 0.05), but the hospital stay of the TFI group was longer than that of the TRI group ((10.1 +/- 4.6) vs (7.2 +/- 2.6) days, P 0.05). CONCLUSION The transradial approach for primary PCI is safe and feasible for elderly patients with AMI.

Clinical outcome of dental implants placed in fibula-free flaps for orofacial reconstruction.

Abstract: Background Functional reconstruction of the jaw defect due to tumor resection poses a challenging problem in maxillofacial surgery. The osteocutaneous fibula free flap in combination with simultaneous or second stage insertion of dental implants has exhibited growing popularity for such reconstructions. This study was aimed at evaluating the clinical status and the success rates of dental implants inserted in fibula-free flaps for orofacial reconstruction following ablation of tumors. Methods We conducted a clinical follow-up study based on 29 patients after oral tumor surgery, who received vascularized fibula bone grafts and endosseous implants for functional jaw reconstruction during a 5-year period. The follow-up protocol included clinical examination and radiological evaluation. The clinical records of the patients were reviewed retrospectively. Information on treatment modalities, dentition, implant parameters, and prostheses was collected and analyzed. Results In general, a high primary stability for implants placed into the free fibula grafts was achieved. The 1-year and 5-year cumulative survival rates of the implants were 96% and 91%, respectively, using the Kaplan-Meier method. The 1-year and 5-year cumulative success rates of implants placed into the fibula bone grafts were 95% and 87%, respectively. The main reasons for failure of the dental implants were infection, tumor recurrence and soft tissue proliferation. The fibula flap presents many advantages for implant placement, but its limited height sometimes makes implant-supported prosthetic rehabilitation difficult. Conclusions Vascularized fibula bone grafts provide a firm basis for the placement of dental implants in jaw reconstruction. Implants placed in fibula bone grafts were shown to integrate normally. The double-barrel technique, or increasing the height of the fibula flap by vertical distraction osteogenesis before implant placement in the mandible, is desirable from a functional and esthetic point of view. Chin Med J 2008;121(19):1861-1865 umor resection in the maxilla or in the mandible can lead to significant facial deformity, altered oral functions, and subsequent psychological problems. Rehabilitation of patients with orofacial defects after tumor resection poses a common and challenging problem in maxillofacial surgery. 1,2 The regeneration of bony defects of the jaws using free vascularized tissue grafts has become a reliable procedure during the last few years. Various donor sites are available to provide vascularized bone grafts for mandibular or maxillary reconstruction such as the fibula flap, the iliac flap, the rib flap and the scapula flap. Vascularized grafts provide a good bulk of bone in which to place implants and a satisfactory contour. Among these alternatives, the fibula-free flap presents many advantages compared with the scapula or the iliac crest. It was demonstrated that the fibula flap offers favorable conditions for implant placement due to its strong bicortical bone. Dental implants contribute significantly to the restoration of adequate function over other tooth-replacement options, because implant-supported prostheses are far more stable. 2-7 The purpose of this study was to evaluate the clinical status and success rates of dental implants inserted in fibula-free flaps used for orofacial reconstruction following ablative tumor surgery.

Altered angiotensin-converting enzyme and its effects on the brain in a rat model of Alzheimer disease.

Abstract: BACKGROUND Alzheimer disease (AD) is a neurodegenerative disease related to aging. At present, its pathological mechanisms remain unclear. Family members of the renin-angiotensin system (RAS) play a role in neuronal plasticity, as well as formation of learning and memory. In this study, we explore the effects of altered angiotensin-converting enzyme (ACE), and investigate the possible mechanisms of perindopril, an ACE inhibitor, on brain structure and function in a rat model of AD, as well as the role that ACE plays in AD. METHODS Sixty Sprague-Dawley rats were selected and randomly divided into 3 groups: control, AD, and perindopril. Each group consisted of 20 rats, with 10 rats for determining pathology, and the remaining 10 rats for quantifying ACE activity. The rat AD model was established by stereotactically injecting amyloid beta protein (A-beta) 1-42 into the right hippocampus. Learning and memory functions were tested using the Y-type electric maze. The number and morphology of abnormal neurons were determined by haematoxylin and eosin staining. Amyloid deposition was measured by Congo red staining. Finally, ACE activity was estimated by spectrophotometry. RESULTS Compared with the control group, the number of times needed to escape electrical stimuli increased (23.70 +/- 3.13, P < 0.001), the number of normal neurons in the CA1 region was reduced (density of 96.5 +/- 32.6/mm, P < 0.001), amyloid deposition was obvious, and ACE activity increased ((34.4 +/- 6.6) nmol x g(-1) x min(-1), P < 0.001) in the AD group. In the perindopril group, the number of times needed to escape electrical stimuli decreased (18.50 +/- 3.66, P < 0.001), the number of abnormal neurons increased (density of CA1 neurons was 180.8 +/- 28.5/mm, P < 0.001), amyloid deposition was reduced, and ACE activity was down-regulated ((26.2 +/- 6.2) nmol x g(-1) x min(-1), P < 0.001). CONCLUSIONS ACE activity increased in the brains of AD rats. Perindopril improved learning and memory in AD rats, which correlated with decreased ACE activity and delayed AD pathogenesis.

Resveratrol reestablishes spermatogenesis after testicular injury in rats caused by 2, 5-hexanedione.

Abstract: BACKGROUND Environmental toxins can destroy the physiological process of spermatogenesis and even lead to male infertility. Resveratrol (RES) is a natural phytoalexin with a wide range of biological activities. Some recent researches have demonstrated that RES can increase sperm output and protect sperm from apoptosis caused by physical damage. However, there is no evidence indicating that it can also exhibit a similar activity in testis injury caused by environmental toxins. This study was designed to evaluate the protective effect of resveratrol on testis damaged by environmental toxins and to elucidate the possible mechanism of its protective effect. METHODS In this study 2, 5-hexanedione (2, 5-HD) was used as the injury agent. Forty male SD rats were randomly divided into 5 groups. During the first 5 weeks, group A was raised normally, groups B, C, D and E were exposed to 1% 2, 5-HD; during the following 9 weeks, group C, D, E received intragastric administration of different concentrations of resveratrol (20 mg x kg(-1) x d(-1), 40 mg x kg(-1) x d(-1) and 80 mg x kg(-1) x d(-1)), while groups A and B were treated by carboxymethylcellulose. Physical signs, body weight gain and testis weight were comparatively observed. Numbers and diameters of seminiferous tubules were analyzed following HE staining. In addition, expression of the c-kit protein and gene in spermatogenic cells in every group was detected with immunohistochemistry, Western blot or RT-PCR. RESULTS The 2, 5-HD treatment resulted in physical signs that became worse and in emarciated testis. HE staining and immunohistochemistry showed that seminiferous tubules became emarcid, obsolete spermatogonia being stagnant and expression of c-kit protein being depressed. After oral administration of resveratrol, the 2, 5-HD-induced physical signs were improved and close to the normal rats. The gain of body weight increased (P < 0.01). The recovery of testis weight was significant (P < 0.01). At the histological level, the seminiferous epithelia began to differentiate (P < 0.01); and even the physiological process of spermatogenesis restarted. Moreover, expression of c-kit protein and gene function resumed, although its expression remained different from the normal group. The diameter of and number of seminiferous tubules and the expression level of c-kit protein and gene activity were much closer to the normal group with increased doses of the resveratrol through oral administration. CONCLUSIONS Resveratrol could ameliorate markedly the dyszoospermia induced by 2, 5-HD and induce spermatogenesis. The expression of c-kit, which is a specific marker protein of spermatogenic cell membranes, could be regulated by resveratrol.

HIV/AIDS epidemiology and prevention in China.

Abstract: OBJECTIVE: To review HIV/AIDS epidemic history current situation and prevention policy in China. Data sources Information included in this article was identified by searching PUBMED (1997 - 2006) online resources using the key terms "HIV/AIDS" "epidemic" "prevention" and "China". Study selection Original milestone articles and critical reviews written by major pioneer investigators of the field were selected. RESULTS: The key issues related to the HIV/AIDS epidemic situation in China and Chinese government prevention policy were summarized. HIV/AIDS epidemic groups and trends for HIV transmission were discussed. CONCLUSION: In January 2006 650 000 people were estimated to be living with HIV in China. The overall HIV/AIDS epidemic is at a low level (0.05%) and concentrated in several at risk populations. However the data show that new cases of HIV infection are growing every year and spreading from at risk populations to the general population. Premier WEN Jia-bao announced the "Four frees and one care" policy and the Chinese government has developed a series of programs with strong policy measures to stop the spread of HIV/AIDS in China.

Prevalence of hypertension among individuals aged 50 years and over and its impact on health related quality of life in a semi-rural area of western Turkey

Abstract: BACKGROUND Hypertension is common, especially in individuals aged 40 years and over, and it affects about half of the population aged 60 years and over. This study aimed to determine the frequency and risk factors of hypertension among individuals aged 50 years and over, and to examine its effect on the health related quality of life (HRQOL). METHODS This population-based cross-sectional study was conducted in two settlements in a region of western Turkey between March 1 and April 30, 2007. A questionnaire concerning life habits associated with hypertension, medical histories, and demographic characteristics was filled in by a face to face interview. The SF-36 scale was used to assess HRQOL. Body mass index (BMI) was calculated by measuring the weight and length of the body. RESULTS Of 1599 individuals living in the region, 1193 participated in the survey (48.3% men and 51.7% women). The overall prevalence rate of hypertension was 59.5% (n=710), being 58.0% in men and 60.9% in women (P > 0.05). The variables that most positively influenced hypertension (P < 0.05, for each one) were older age (especially the age group of those aged 60 and over), single, no health insurance, consumption of animal fat in meals, and family history of hypertension. The HRQOL of the patients with hypertension was lower than that of those without hypertension (P < or = 0.05). The HRQOL was better in hypertensive patients whose blood pressure was under control, whereas it was worse in those with at least one chronic disorder accompanying hypertension (P < 0.05, for each one). CONCLUSIONS Great emphasis should be placed on the need for a public health program for the detection, prevention, and control of hypertension, including other risk factors, as well as for the modification of foods and life habits, specifically in individuals who are most likely to be at risk of hypertension.

Magnetic resonance susceptibility weighted imaging in detecting intracranial calcification and hemorrhage.

Abstract: BACKGROUND: Computed tomography (CT) is better than routine magnetic resonance imaging (MRI) in detecting intracranial calcification. This study aimed to assess the value of MR susceptibility weighted imaging (SWI) in the detection and differentiation of intracranial calcification and hemorrhage. METHODS: Enrolled in this study were 35 patients including 13 cases of calcification demonstrated by CT and 22 cases of intracerebral hemorrhage. MR sequences used in all the subjects included axial T1WI, T2WI and SWI. The phase shift (PS) of calcification and hemorrhage on SWI was calculated and their signal features on corrected phase images were compared. The sensitivity of T1WI, T2WI and SWI in detecting intracranial calcification and hemorrhage was analyzed statistically. RESULTS: The detection rate of SWI for cranial calcification was 98.2%, significantly higher than that of T1WI and T2WI. It was not significantly different from that of CT (P > 0.05). There were 49 hemorrhagic lesions at different stages detected on SWI, 30 on T2WI and 18 on T1WI. The average PS of calcification and hemorrhage was +0.734 +/- 0.073 and -0.112 +/- 0.032 respectively (P < 0.05). The PS of calcification was positive and presented as a high signal or the mixed signal dominated by a high signal on the corrected phase images, whereas the PS of hemorrhage was negative and presented as a low signal or the mixed signal dominated by a low signal. CONCLUSIONS: SWI can accurately demonstrate intracranial calcification, not dependant on CT. Being more sensitive than routine MRI in detecting micro-hemorrhage, SWI may play an important role in differentiating cerebral diseases associated with calcification or hemorrhage.

Characterization of multidrug-resistant and metallo-beta-lactamase-producing Pseudomonas aeruginosa isolates from a paediatric clinic in China

Abstract: Background In the present study, we characterized multidrug-resistant Pseudomonas aeruginosa (MDRP) clinical isolates from a paediatric facility and investigated the types and features of the metallo-beta-lactamases (MBLs) produced by carbapenem-resistant strains. Methods Four hundred and ninety-eight strains of Pseudomonas aeruginosa were isolated from patients at Beijing Children's Hospital between January 2005 and December 2006. The minimal inhibition concentrations (MICs) of the strains for 13 antibiotics were measured. A combination of the E test and PCR amplification/DNA sequencing was used to define the carbapenem-resistant strains. Results We found that 24.1% (120/498) of the isolates were MDRP. The frequencies of resistance to imipenem and meropenem were 34.2% and 35.8%, respectively, and the MIC50 and MIC90 values for the two antibiotics were identical at 4 microg/ml and 32 microg/ml, respectively. The detection rate for carbapenem resistance was 49.2% (59/120). Among the 59 carbapenem-resistant Pseudomonas aeruginosa strains, 39 (66.1%) were positive for the MBL genotype; 35 (89.7%) strains carried the bla(IMP) gene and 4 (10.3%) strains carried the bla(VIM) gene. Neither bla(SPM) nor bla(GIM) was amplified from any of the 59 isolates. DNA sequencing revealed that IMP-1 was present in 35 IMP-producing isolates and VIM-2 was detected in four VIM-producing isolates. Conclusions These MDRP isolates exhibited high frequencies of resistance to carbapenems among clinical isolates from a paediatric facility in Beijing, China. The production of MBL appears to be an important mechanism for carbapenem resistance in Pseudomonas aeruginosa.

Identification of differential gene expression profiles of radioresistant lung cancer cell line established by fractionated ionizing radiation in vitro.

Abstract: Background Radiotherapy plays a critical role in the management of non-small cell lung cancer (NSCLC). This study was conducted to identify gene expression profiles of acquired radioresistant NSCLC cell line established by fractionated ionizing radiation (FIR) by cDNA microarray. Methods The human lung adenocarcinoma cell line Anip973 was treated with high energy X-ray to receive 60 Gy in 4 Gy fractions. The radiosensitivity of Anip973R and its parental line were measured by clonogenic assay. Gene expression profiles of Anip973R and its parental line were analyzed using cDNA microarray consisting of 21 522 human genes. Identified partly different expressive genes were validated by quantitative reverse transcription-polymerase chain reaction (Q-RT-PCR). Results Fifty-nine upregulated and 43 downregulated genes were identified to radio-resistant Anip973R. Up-regulated genes were associated with DNA damage repair (DDB2), extracellular matrix (LOX), cell adhesion (CDH2), and apoptosis (CRYAB). Down-regulated genes were associated with angiogenesis (GBP-1), immune response (CD83), and calcium signaling pathway (TNNC1). Subsequent validation of selected eleven genes (CD24, DDB2, IGFBP3, LOX, CDH2, CRYAB, PROCR, ANXA1 DCN, GBP-1 and CD83) by Q-RT-PCR was consistent with microarray analysis. Conclusions Fractionated ionizing radiation can lead to the development of radiation resistance. Altered gene profiles of radioresistant cell line may provide new insights into mechanisms underlying clinical radioresistance for NSCLC.

Detection of recent HIV-1 infections among men who have sex with men in Beijing during 2005 - 2006.

Abstract: Background Men who have sex with men (MSM) have become one of the most risky populations for HIV infection in China. Though several cross-sectional sero-prevalence studies have been conducted, the annual HIV incidence remains unknown in this population. Methods We applied IgG-capture BED-enzyme immunoassay (BED-CEIA) to define the recent HIV-1 infections among MSM in Beijing in the years 2005 and 2006 and the annual HIV incidence was estimated. Results Overall, 1067 MSM samples were collected, including 526 samples in the year 2005 and 541 in 2006. In 2005, of 17 HIV seropositive samples, 7 were identified as recent HIV-1 infections and the estimated HIV infection incidence was 2.9% per year (95% CI, 0.8% - 5.0%). In 2006, of 26 HIV seropositive samples, 9 were identified as recent HIV-1 infections and the estimated annual incidence was 3.6% (95% CI, 1.3% - 5.9%), which was 0.7% higher than that in 2005. Individuals engaging in male group sexual intercourse (5.17% vs 0.87%, P = 0.019) and having receptive anal sexual intercourse more than five times (2.79% vs 0.33%, P = 0.047) in the past 6 months significantly increase the risk of being infected by HIV-1. Conclusions A high level of annual HIV-1 infection incidence was observed among MSM in Beijing for the consecutive years 2005 and 2006 with a continuous increasing trend. The rising incidence and related high risk behavior among MSM alarmed the health authorities and calls for more effective intervention strategies among this population.

Loss of melanopsin-containing retinal ganglion cells in a rat glaucoma model.

Abstract: Background Glaucoma can cause progressive damage to retinal ganglion cells. These cells can be classified as cells projecting to the superior colliculus and melanopsin-containing retinal ganglion cells, which project to the suprachiasmatic nucleus. This study was to investigate the effects of chronic intraocular pressure elevation on melanopsin-containing retinal ganglion cells in rats. Methods Chronic intraocular pressure elevation was induced in one eye of adult Wistar rats by cauterization of three episcleral veins. Intraocular pressure was measured at different intervals with a rebound tonometer. Superior collicular retinal ganglion cells were retrogradely labeled from the superior colliculus with Fluorogold. Melanopsin-containing retinal ganglion cells were visualized by free-floating immunohistochemistry on whole-mount retinas. The number of labeled superior collicular and melanopsin-containing retinal ganglion cells were counted in the sample areas on flat-mounted retinas. Results Compared with contralateral control eyes, the numbers of both superior collicular and melanopsin-containing retinal ganglion cells were significantly reduced after 12 weeks of experimental intraocular pressure elevation ((2317.41 +/- 29.96)/mm(2) vs (1815.82 +/- 24.25)/mm(2); (26.20 +/- 2.10)/mm(2) vs (20.62 +/- 1.52)/mm(2), respectively). The extent of cell loss of the two types of retinal ganglion cells was similar. However, no morphologic changes were found in melanopsin-containing retinal ganglion cells. Conclusion Both melanopsin-containing and superior collicular retinal ganglion cells were damaged by chronic ocular hypertension, indicating that glaucomatous neural degeneration involves the non-image-forming visual pathway.

Effects of spironolactone on electrical and structural remodeling of atrium in congestive heart failure dogs

Abstract: BACKGROUND Renin-angiotensin-aldosterone system has been demonstrated to be associated with both congestive heart failure (CHF) and atrial fibrillation (AF). This study investigated the effects of spironolactone, a kind of aldosterone antagonist, on atrial electrical remodeling and fibrosis in CHF dogs induced by chronic rapid ventricular pacing. METHODS Twenty one dogs were randomly divided into sham-operated group, control group, and spironolactone group. In control group and spironolactone group, dogs were ventricular paced at 220 beats per minute for 6 weeks. Additionally, spironolactone at 15 mg x kg(-1) x d(-1) was given to dogs 1 week before rapid ventricular pacing until pacing stopped. Transthoracic and transoesophageal echocardiographic examinations were performed to detect structural and functional changes of the atrium. Swan2 Ganz floating catheters were used to measure hemadynamics variances. Atrial effective refractory period (AERP), AERP dispersion (AERPd), intra- and inter-atrium conduction time (CT) and intra-atrium conduction velocity (CV) were determined. The inducibility and duration of AF were also measured in all groups. Finally, atrial fibrosis was quantified with Masson staining. RESULTS AERP did not change significantly after dogs were ventricular paced for 6 weeks. However, AERPd, intra- and inter-atrium CT increased significantly, and CV decreased apparently, which was negatively correlated to the atrial fibrosis (r = -0.74, P < 0.05). Simultaneously, left atriums were enlarged and cardiac hemadynamics worsened in pacing dogs. Although spironolactone could not affect cardiac hemadynamics effectively, it can obviously improve left atrial ejection fraction (P < 0.05). Spironolactone treatment did not alter AERP duration, but this medicine dramatically decreased AERPd (P < 0.05), shortened intra- and inter-atrium conduction time (P < 0.05), and increased atrium CV. Moreover, spironolactone decreased the inducibility and duration of AF (P < 0.05), as well as atrial fibrosis (P < 0.01) induced by chronic rapid ventricular pacing. CONCLUSION Spironolactone contributes to AF prevention in congestive heart failure dogs induced by chronic rapid ventricular pacing, which is related to atrial fibrosis reduction and independent of hemadynamics.

Potential infections of H5N1 and H9N2 avian influenza do exist in Guangdong populations of China.

Abstract: Background Southeast China is one of the sites of influenza origin. During 2003--2004, nine avian influenza outbreaks took place in Guangdong Province. But no human case was reported. To examine the status of potential human infection by human influenza (H1N1, H3N2) and avian influenza (H5N1, H7N7, H9N2) in the avian influenza epidemic area of Guangdong Province, China, we conducted a seroepidemiologic survey in the people of this area from April to June of 2004. Methods Three out of 9 H5N1 avian influenza affected poultry areas in Guangdong were randomly selected, and the population living within 3 kilometers of the affected poultries were chosen as the survey subjects. One thousand two hundred and fourteen people were selected from 3 villages at random. Human and avian influenza antibody titers were determined by hemagglutination-inhibition (HI) test and microneutralization test (MNT). Results The positive rate of antibody to H5N1 was 3.03% in the occupational exposure group and 2.34% in general citizens group; that of H9N2 was 9.52% in the occupational exposure group and 3.76% in the general citizens group. Moreover one case in the occupational exposure group was positive for H7N7. One year later, all previously positive cases had become negative except for one H5N1-positive case. Conclusion The observations imply that H5N1 and H9N2 avian influenza silent infections exist in Guangdong populations.

Cytotoxin-associated gene-A-seropositive virulent strains of Helicobacter pylori and atherosclerotic diseases: a systematic review.

Abstract: Objective A systematic meta-analysis was performed to explore the role of cytotoxin-associated gene-A (CagA) seropositive strains of Helicobacter pylori (H pylori) in the pathogenesis of atherosclerotic diseases Data sources Data from Medline, EMBASE, CBMdisc, CNKI and the Cochrane Collaboration database were searched Similar search strategies were applied to each of these databases Study selection The review was restricted to the case-control studies on infective, chronic virulent CagA strains of H pylori, involving the risk of ischemic stroke and coronary heart disease, ineligible studies were excluded Two reviewers independently extracted the data and assessed study quality Results Totally 26 case-control studies (11 studies on ischemic stroke and 15 studies on coronary heart disease) were retrieved and considered The combined data revealed that the chronic seropositive virulent strains of H pylori infection had a trend of increasing the risk of ischemic strokes and coronary heart diseases, yielding pooled ORs of 268 (95% CI: 220, 327) and 211 (95% CI: 170, 262), respectively We also performed subgroup analyses, dividing the total population into Caucasian and Chinese subgroups Through the subgroup analysis, no significant difference was found between the subgroups Conclusions Our results support the hypothesis that CagA-seropositive strains infection is significantly associated with susceptibility to ischemic strokes and coronary heart diseases The magnitude of the association with atherosclerotic diseases needs to be confirmed by prospective studies and the studies on CagA-seropositive strains eradication are more important

Risk factors related to hospital mortality in patients with isolated traumatic acute subdural haematoma: analysis of 308 patients undergone surgery.

Abstract: BACKGROUND Acute subdural haematoma (ASDH) is a common traumatic brain injury with a relatively high mortality rate. However, few studies have examined the factors predicting the outcome of isolated traumatic ASDH. This clinical study examined the hospital mortality and analyzed the risk factors for mortality in patients treated surgically for isolated traumatic ASDH. METHODS We collected 308 consecutive patients who underwent neurosurgery for isolated traumatic ASDH between January 1999 and December 2007 and used multivariate Logistic regression analysis to evaluate the influence of 11 clinical variables on hospital mortality. RESULTS The overall hospital mortality was 21.75% (67/308). Age (OR = 1.807), preoperative Glasgow Coma Score (OR = 0.316), brain herniation (OR = 2.181) and the time from trauma to decompression (OR = 1.815) were independent predictors of death, while no independent association was observed between hospital mortality and haematoma volume, midline shift, acute brain swelling or brain herniation duration, although these variables were correlated with hospital mortality in univariate analyses. CONCLUSIONS This study identified the risk factors for hospital mortality in patients who underwent surgical treatment for isolated traumatic ASDH. An increased risk of death occurs in patients who are over 50 years of age and have lower preoperative Glasgow Coma Scores, the presence of brain herniation and a long interval between trauma and decompression. The findings should help clinicians determine management criteria and improve survival.

Genetic variants in three genes and smoking show strong associations with susceptibility to exudative age-related macular degeneration in a Chinese population.

Abstract: BACKGROUND The present study was undertaken to replicate the associations of representative polymorphisms in three genes (complement factor H (CFH), complement factor B (BF) and HtrA serine peptidase 1 (HTRA1)) with exudative age-related macular degeneration (AMD) in a Han Chinese population, and to test if the modifiable environmental factors affect AMD susceptibility associated with different type of genotype in these genes. METHODS An age, gender and ethnicity matched case-control study was conducted to genotype the representative single neucleotide polymorphisms (SNPs) loci including rs1061170 and rs1410996 in CFH, rs641153 and rs4151667 in BF and rs11200638 in HTRA1 gene in 144 exudative AMD patients and 126 normal controls using PCR-RFLP and direct resequencing. The demographic characteristics and behavioral risk factors were also recorded. Allelic and genotypic associations for individual SNP and joint associations with two loci were performed. The gene-gene and gene-environment interactions were analyzed using multivariate non-conditional Logistic regression analysis. RESULTS The C risk allele frequencies for CFH Y402H (rs1061170) in cases and controls were 12.5% and 5.4% respectively, which were much lower than those in Caucasians (P < 0.001). Compared with TT homozygous genotype, the CT heterozygous genotype was positively associated with AMD with odds ratio (OR) of 3.23 (1.36 - 5.07). However, the population attributable risk (PAR) of C allele was only 3.3% (1.4% - 4.3%). rs1410996 was also associated with AMD independent of Y402H. The ORs of exudative AMD for individuals carrying one copy risk allele and two copy risk alleles were 2.57 (1.21 - 5.45) and 4.76 (2.15 - 10.55) respectively, with correspondent PARs of 28.3% (2.0% - 40.5%) and 38.2% (21.8% - 45.4%). rs11200638 in HTRA1 was another susceptible locus for AMD and the risk homozygotes were significantly susceptible for exudutive AMD (OR = 3.98, 1.88 - 8.43) with PAR of 38.9% (24.3% - 45.8%). Education status and cigarette smoking were also related to exudative AMD. After controlling for environmental risk factors, CFH and HTRA1 SNPs were independently associated with exudative AMD, with OR of 3.50 (1.45 - 8.45) for CT genotype in Y402H, 3.34 (1.33 - 8.36) for GG genotype in rs1410996 and 3.85 (1.58 - 9.42) for AA genotype in rs11200638 respectively. The interaction analysis between gene and environmental factors showed that smoking synergistically increased susceptibility of AMD for heterozygotes of rs1410996, with OR(interaction) of 7.33 (P(interaction) = 0.029). CONCLUSIONS In a Han Chinese population, CFH and HTRA1 polymorphisms appear to be independently and possibly additively hereditary contributors to exudative AMD. Y402H polymorphism conferred a significant but relatively lower contribution in Chinese than in Caucasians with a low frequency of risk allele. The gene-environment interaction may be a best way to encourage those with a high genetic risk to prevent AMD by avoiding modifiable factors until there is effective treatment for AMD.

Transplantation of autologous bone marrow mononuclear cells for patients with lower limb ischemia.

Abstract: Background Many treatment options for lower limb ischemia are difficult to apply for the patients with poor arterial outflow or with poor general conditions. The effect of medical treatment alone is far from ideal, especially in patients with diabetic foot. A high level amputation is inevitable in these patients. This study aimed to explore the effect of transplantation of autologous bone marrow mononuclear cells on the treatment of lower limb ischemia and to compare the effect of intra-arterial transplantation with that of intra-muscular transplantation. Methods In this clinical trial, 32 patients with lower limb ischemia were divided into two groups. Group 1 (16 patients with 18 affected limbs) received transplantation of autologous bone marrow mononuclear cells by intra-muscular injection into the affected limbs; and group 2 (16 patients with 17 affected limbs) received transplantation of autologous bone marrow mononuclear cells by intra-arterial injection into the affected limbs. Rest pain, coldness, ankle/brachial index (ABI), claudication, transcutaneous oxygen pressure (tcPO 2 ) and angiography (15 limbs of 14 patients) were evaluated before and after the mononuclear cell transplantation to determine the effect of the treatment. Results Two patients died from heart failure. The improvement of rest pain was seen in 76.5% (13/17) of group 1 and 93.3% (14/15) of group 2. The improvement of coldness was 100% in both groups. The increase of ABI was 44.4% (8/18) in group 1 and 41.2% (7/17) in group 2. The value of tcPO 2 increased to 20 mmHg or more in 20 limbs. Nine of 15 limbs which underwent angiography showed rich collaterals. Limb salvage rate was 83.3% (15/18) in group 1 and 94.1% (16/17) in group 2. There was no statistically significant difference in the effectiveness of the treatment between the two groups. Conclusions Transplantation of autologous bone marrow mononuclear cells is a simple, safe and effective method for the treatment of lower limb ischemia, and the two approaches for the implantation, intra-muscular injection and intra-arterial injection, show similar results.

Effects of nitric oxide and hydrogen sulfide on the relaxation of pulmonary arteries in rats

Abstract: BACKGROUND The balance between vasodilation and vasoconstriction plays a major role in maintaining vascular homeostasis However, the underlying mechanisms are unclear More and more evidence suggested that there was an interaction in the regulation of vasorelaxation between nitric oxide (NO) and hydrogen sulfide (H(2)S) We explored the interaction between and effects of NO and H(2)S on the relaxation of pulmonary arteries in rats METHODS Seven male Sprague-Dawley rats were anaesthetized with chloral hydrate and the pulmonary arteries of each rat separated for the study of vascular activities The vasorelaxing activities of pulmonary artery rings in response to different doses of a NO donor, sodium nitroprusside (SNP), or a H(2)S donor, sodium hydrogen sulfide (NaHS), were measured in vitro When pulmonary artery rings were treated with a cystathionine-gamma-lyase inhibitor, DL-propargylglycine, in the presence of SNP or a nitric oxide synthase inhibitor, N(omega)-nitro-L-arginine methyl ester, in the presence of NaHS, the changes in relaxing activities were analyzed RESULTS The relaxation of pulmonary artery rings was in a dose dependent manner in response to either SNP or NaHS The relaxation rates of pulmonary artery rings increased from (3090+/-462)% to (6050+/-808)% when the concentration of SNP increased from 1 micromol/L to 3 micromol/L and from (2613+/-412)% to (5309+/-1401)% when the concentration of NaHS increased from 25 micromol/L to 100 micromol/L However, when appropriate inhibitor was added, the relaxation responses to SNP and NaHS decreased CONCLUSIONS The results suggested that similarly to NO, H(2)S acted as a vasorelaxant either independently of, or synergistically with NO in the regulation of vasorelaxation The interaction between NO and H(2)S played an important role in regulating relaxing activities of pulmonary arteries

Clinical update of pulsed electromagnetic fields on osteoporosis.

Abstract: Objective To understand the effects of low-frequency pulsed electromagnetic fields (PEMFs) on chronic bony pain, bone mineral density (BMD), bone strength and biochemical markers of bone metabolism in the patients of osteoporosis. Data sources Using the key words "pulsed electromagnetic fields" and "osteoporosis", we searched the PubMed for related studies published in English from January 1996 to December 2007. We also searched the China National Knowledge Infrastructure (CNKI) for studies published in Chinese from January 1996 to December 2007. Inclusion criteria (1) all articles which referred to the effects of low-frequency pulsed magnetic fields on osteoporosis either in primary osteoporosis or secondary osteoporosis; (2) either observational studies or randomized controlled studies. Exclusion criteria (1) articles on experimental studies about osteoporosis; (2) repetitive studies; (3) case reports; (4) meta analysis. Results Totally 111 related articles were collected, 101 of them were published in Chinese, 10 were in English. Thirty-four were included and the remaining 84 were excluded. Conclusions Low-frequency PEMFs relieves the pain of primary osteoporosis quickly and efficiently, enhances bone formation and increases BMD of secondary osteoporosis. But the effects of PEMFs on bone mineral density of primary osteoporosis and bone resorption were controversial.

Early neurosurgical intervention of spinal cord contusion: an analysis of 30 cases.

Abstract: Background The incidence of spinal injury with spinal cord contusion is high in developed countries and is now growing in China. Furthermore, spinal cord injury happens mostly in young people who have a long life expectance. A large number of patients thus are wheelchair bound for the rest of their lives. Therefore, spinal cord injury has aroused great concern worldwide. Despite great efforts, recovery from spinal cord injury remains unsatisfactory. Based on the pathology of spinal cord contusion, an idea of early neurosurgical intervention has been formulated in this study. Methods A total of 30 patients with "complete" spinal cord injury or classified as American Spinal Injury Association (ASIA)-A were studied. Orthopedic treatment of the injured vertebra (e), internal fixation of the vertebral column, and bilateral laminectomy for epidural decompression were followed directly by neurosurgical management, including separation of the arachnoid adhesion to restore cerebrospinal fluid flow and debridement of the spinal cord necrotic tissue with concomitant intramedullary decompression. Rehabilitation started 17 days after the operation. The final outcome was evaluated after 3 months of rehabilitation. Pearson chi-square analysis was used for statistical analysis. Results All the patients recovered some ability to walk. The least recovered patients were able to walk with a wheeled weight support and help in stabilizing the weight bearing knee joint (12 cases, 40%). Thirteen patients (43%) were able to walk with a pair of crutches, a stick or without any support. The timing of the operation after injury was important. An optimal operation time window was identified at 4 - 14 days after injury. Conclusions Early neurosurgical intervention of spinal cord contusion followed by rehabilitation can significantly improve the locomotion of the patients. It is a new idea of a therapeutic approach for spinal cord contusion and has been proven to be very successful.

Protective effects of emodin and astragalus polysaccharides on chronic hepatic injury in rats.

Abstract: Background Chinese medicine plays an important role in hepatoprotective treatment. This study was conducted to investigate the protective effects of emodin and astragalus polysaccharides (APS) in a rat model of chronic hepatic injury. Methods Chronic hepatic injury was induced by hypodermic injection of an olive oil solution containing 40% carbon tetrachloride (CCl(4)) twice a week, in addition to a diet of 79.5% maizena, 20% fat, 0.5% cholesterol, and 10% alcohol in the drinking water ad libitum for 12 weeks. Meanwhile, the rats were exposed to different concentrations of emodin (40 mg x kg(-1) x d(-1)), APS (200 mg x kg(-1) x d(-1)), combination drug (emodin 40 mg x kg(-1) x d(-1) combined with APS 200 mg x kg(-1) x d(-1)) and colchicine (0.1 mg x kg(-1) x d(-1)) in parallel by oral gavage (once a day for 12 weeks). At the end of 12 weeks, blood serum and liver tissue were taken. Serum was collected to determine the levels of total bilirubin (TBIL), alanine transaminase (ALT), aspartate transaminose (AST), and albumin (ALB). Liver and spleen indexes were assayed, followed by the measurements of the liver associated enzyme superoxide dismutase (SOD) and malondialdehyde (MDA). Histopathological changes were studied using optical microscopy. Results Splenohepatomegalia was alleviated and serum levels of TBIL and ALT were reduced in the groups treated with emodin and APS when compared to the control group. In addition, the ALB level in the APS and combination groups was higher. Similarly, the SOD activity of liver homogenates was significantly higher in the groups treated with emodin and APS, while administration of the herbal derivatives prevented the elevation in MDA levels. Histological analysis showed that the APS and combination groups significantly ameliorated the hepatic injury. Conclusions Co-administration of emodin and APS demonstrated a synergistic action in reducing ALT and restoring ALB in the serum from a rat model of chronic hepatic injury. Emodin and APS may ameliorate the CCl(4)-induced hepatic injury in rats by elevating antioxidant-enzyme activities and reducing lipid peroxidation.

Simvastatin attenuates bleomycin-induced pulmonary fibrosis in mice

Abstract: Background Bleomycin-induced fibrosis is extensively used to model aspects of the pathogenesis of interstitial pulmonary fibrosis. This study aimed to determine the benefic effects and mechanisms of simvastatin on bleomycininduced pulmonary fibrosis in mice. Methods Bleomycin-induced pulmonary fibrosis mice were administered with simvastatin in different doses for 28 days. We measured inflammatory response, fibrogenic cytokines and profibrogenic markers in both bleomycin-stimulated and control lungs, and correlated these parameters with pulmonary fibrosis. Results Simvastatin attenuated the histopathological change of bleomycin-induced pulmonary fibrosis and prevented the increase of lung hydroxyproline content and collagen (I and III) mRNA expression induced by bleomycin. Moreover, simvastatin down-regulated the increased expression of transforming growth factor-β1 (TGF-β1) and connective tissue growth factor (CTGF) induced by bleomycin at both gene and protein levels. Simultaneously, the accumulation of neutrophils and lymphocytes and the increased production of tumor necrosis factor-α (TNF-α) in bronchial alveolar lavage fluid were inhibited by simvastatin in early inflammatory phase after bleomycin infusion. The higher dose of simvastatin was associated with a more significant reduction in these inflammatory and fibrotic parameters. Furthermore, the inactivation of p38, RhoA and Smad2/3 signaling pathways was observed during simvastatin administration. Conclusions Simvastatin attenuated bleomycin-induced pulmonary fibrosis, as indicated by decreases in Ashcroft score and lung collagen accumulation. The inhibitory effect of simvastatin on the progression of pulmonary fibrosis may be demonstrated by reducing inflammatory response and production of TGF-β1 and CTGF. These findings indicate that simvastatin may be used in the treatment of pulmonary fibrosis. Chin Med J 2008;121(18):1821-1829